STATE OF ILLINOIS

HEALTH FACILITIES AND SERVICES REVIEW BOARD 525 WEST JEFFERSON ST. • SPRINGFIELD, ILLINOIS 62761 • (217) 782-3516 FAX: (217) 785-4111

DOCKET ITEM: C-03

BOARD MEETING: December 4, 2018

EXEMPTION NUMBER: E-060-18

EXEMPTION APPLICANT(S): Hispanic American Endoscopy Center, L.L.C. and 3536 Fullerton, L.L.C. FACILITY NAME and LOCATION: Hispanic American Endoscopy Center, L.L.C d/b/a Chicago Surgery Center, LLC, Chicago, Illinois

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STATE BOARD STAFF REPORT CHANGE OF OWNERSHIP EXEMPTION REQUEST

I. The Exemption Application

The Applicants (Hispanic American Endoscopy Center, L.L.C. and 3536 Fullerton, L.L.C.) propose a change of ownership of Hispanic American Endoscopy Center, L.L.C d/b/a Chicago Surgery Center, LLC a single specialty ASTC located at 3536 Fullerton Avenue, Chicago, Illinois. Dr. Roman Garcia owns 100% of Hispanic American Endoscopy Center, L.L.C. and proposes to sell his interest to Dr. Ryan Rosenthal and Dr. Igor Russo, each will have a 50% interest in the ASTC. The operating entity will remain Hispanic American Endoscopy Center, L.L.C. and the owner of the site is 3536 Fullerton L.L.C. The cost of the purchase is $2,000,000. The expected completion date is December 31, 2018.

II. Applicable Rules

The Illinois Health Facilities Planning Act defines a change of ownership as

“. . . a change in the person who has ownership or control of a health care facility’s physical plant and capital assets. A change in ownership is indicated by the following transactions: sale, transfer, acquisition, lease, change of sponsorship or other means of transferring control.”

The State Board’s rule (77 IAC 1130.500 & 77 ILAC 1130.520) specifies the requirements necessary for a change of ownership exemption application to be filed with the State Board. The State Board may, by rule, delegate authority to the Chairman to grant permits or exemptions when applications meet all of the State Board's review criteria and are unopposed [20 ILCS 3960/5]. An exemption shall be approved when information required by the Board by rule is submitted [20 ILCS 3960/6].

The State Board Staff Notes: No support or opposition letters were submitted and there

was no request for a public hearing. All of the requirements of the State Board have been met.

Chicago Surgery Center, LLC

Net Patient Revenue $1,819,711 $3,226,383 $284,687 Charity Care Charges $3,750 $0 $1,350 Cost of Charity Care $3,750 $0 $1,350

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STATE BOARD STAFF FINDS THE EXEMPTION FOR CHANGE OF OWNERSHIP IN CONFORMANCE WITH CRITERIA (77 ILAC 1130.500 & 77 ILAC 1130.520)

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E-060-18 Chicago Surgery Center - Chicago

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